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Journal Information
Vol. 43. Issue 5.
Pages 289-291 (January 2007)
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Vol. 43. Issue 5.
Pages 289-291 (January 2007)
Case Reports
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Severe Obstructive Sleep Apnea Syndrome in a Toddler
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Virginia León Mirandaa,
Corresponding author
virginia_leon@hotmail.com

Correspondence: Dra. V. León Miranda. Unidad de Sueño. Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Manuel Siurot, s/n. 41013 Sevilla. España
, Ángeles Sánchez Armengola, Aránzazu Ruiz Garcíaa, Carmen Carmona Bernala, Georgina Botebol Benhamoub, Francisco Capote Gila
a Unidad de Sueño, Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain
b Servicio de Neurología y Neurofisiología Clínica, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain
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We report the case of a 3-year-old boy who had experienced intense snoring, frequent awakenings, intense respiratory effort during sleep, and delayed growth starting at the age of 15 months. He underwent adenoidectomy at 18 months. Symptoms initially improved but reappeared 3 months after surgery. He underwent a second adenoidectomy, this time with tonsillectomy, but there was no significant clinical improvement. Polysomnography revealed severe sleep apnea-hypopnea with an apnea-hypopnea index of 45. Continuous positive airway pressure improved sleep quality, although some symptoms, mainly snoring, persisted. A third adenoidectomy was necessary to normalize his breathing pattern during sleep.

Key words:
Obstructive sleep apnea syndrome
Infancy
Adenoidectomy

Describimos el caso de un paciente varón de 3 años de edad, que desde los 15 meses presentaba un cuadro clínico consistente en ronquidos intensos, despertares frecuentes, esfuerzo respiratorio intenso durante el sueño y retraso del desarrollo pondoestatural. Se le practicó una adenoidecto-mía a los 18 meses de edad, con mejoría inicial de los sínto-mas, que sin embargo reaparecieron a los 3 meses de la ciru-gía. Se le realizó una segunda adenoidectomía, acompañada esta vez de amigdalectomía, sin mejoría significativa de la clínica. Se le efectuó una polisomnografía, que resultó diag-nóstica de síndrome de apneas-hipopneas durante el sueño de carácter grave, con un índice de apneas-hipopneas de 45. Tras comenzar tratamiento con presión positiva continua de la vía aérea mejoró la calidad del sueño, pero persistieron algunos de los síntomas, fundamentalmente el ronquido. Para normalizar su patrón respiratorio durante el sueño re-quirió, finalmente, una tercera adenoidectomía.

Palabras clave:
Síndrome de apnea obstructiva del sueño
Infan-cia
Adenoidectomía
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